Which are the most common therapeutic surgeries for pleural mesothelioma?


The most common therapeutic surgeries for pleural mesothelioma, a rare and aggressive cancer affecting the lining of the lungs (the pleura), are:

  1. Pleurectomy/Decortication (P/D): This surgery involves the removal of the pleura (the lining of the lung) to take out as much of the cancer as possible. The procedure may also involve removing part of the diaphragm, the pericardium (the lining around the heart), and/or part of the lung in more extensive operations. P/D aims to remove all visible tumors while preserving lung function.
  2. Extrapleural Pneumonectomy (EPP): EPP is another significant surgical option for mesothelioma. This more radical procedure involves the removal of the entire lung on the affected side, along with the pleura, diaphragm, and pericardium. EPP is considered for patients with more advanced disease and aims to remove as much cancer as possible. However, it’s worth noting that EPP is a highly invasive surgery with a significant impact on quality of life and lung function.
  3. Cytoreductive Surgery (CRS): While CRS is more commonly associated with peritoneal mesothelioma (affecting the abdominal cavity), it involves removing as much of the tumor mass as possible and is sometimes mentioned in the context of pleural mesothelioma. For pleural mesothelioma, the concept would similarly involve removing tumor tissue to reduce the cancer burden. CRS for peritoneal mesothelioma is often followed by Hyperthermic Intraperitoneal Chemotherapy (HIPEC), a treatment that delivers heated chemotherapy directly into the abdominal cavity post-surgery to kill any remaining cancer cells.

Patients who undergo these surgeries often receive additional treatments such as chemotherapy, radiation therapy, or immunotherapy to target any residual cancer cells, improve survival rates, and reduce the risk of recurrence. The choice between these surgeries depends on various factors, including the stage and subtype of mesothelioma, the patient’s overall health, and lung function. A multidisciplinary team of specialists typically evaluates patients to determine the most appropriate treatment plan.